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Why try: Temozolomide/Cisplatin as Adjuvant Therapy-Resected Mucosal Melanoma

Forums Mucosal Melanoma Community Why try: Temozolomide/Cisplatin as Adjuvant Therapy-Resected Mucosal Melanoma

  • Post
    JerryfromFauq
    Participant

      Temozolomide Plus Cisplatin as Systemic Adjuvant Therapy for Resected Mucosal Melanoma https://clincancerres.aacrjournals.org/content/19/16/4488.full

      I know several people that have recently been started on the above treatmetn.  They have been being asked why they are being given these OLD drugs.  This article is the study that is the basis for this treatment for mucosal melanoma patients.  I have not seen it tied to specific Mutations, but learning what mutations have been involved in these trials will be very interesting.  (Suspect C-kit, NRAS and BRAF to be the 3 main over-expresions/mutations involve)

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      The endpoints were relapse-free survival (RFS), overall survival (OS), and toxicities.

      Results: One hundred and eighty-nine patients were enrolled and finally analyzed. With a median follow-up of 26.8 months, the median RFS was 5.4, 9.4, and 20.8 months for group A, B, and C, respectively. Estimated median OS for group A, B, and C was 21.2, 40.4, and 48.7 months, respectively. Patients treated with temozolomide plus cisplatin showed significant improvements in RFS (P < 0.001) and OS (P < 0.01) than those treated with either HDI or surgery alone. Toxicities were generally mild to moderate.

      Conclusion: Both temozolomide-based chemotherapy and HDI are effective and safe as adjuvant therapies for resected mucosal melanoma as compared with observation alone. However, HDI tends to be less effective than temozolomide-based chemotherapy for patients with resected mucosal melanoma in respect to RFS. The temozolomide plus cisplatin regimen might be a better choice for patients with resected mucosal melanoma. Clin Cancer Res; 19(16); 4488–98. ©2013 AACR.

       

      Translational Relevance

      Mucosal melanoma is rare and of extremely poor prognosis. However, standard adjuvant therapy for mucosal melanoma has not been established. The importance of our study is that we provide clinical data showing that high-dose IFN-α2b (HDI) and temozolomide plus cisplatin may be advised to patients with mucosal melanoma in stages II/III and after surgical removal of primary mucosal melanoma. The significance of the study is that temozolomide plus cisplatin regimen, likely better than HDI, may be a choice of adjuvant therapy for patients with mucosal melanoma in respect to relapse-free survival (RFS) and possibly overall survival (OS). Our study shows that both adjuvant regimens are safe and well tolerated for patients with resected mucosal melanoma. Even for patients harboring c-kit or BRAF mutations that are potential targets for targeted therapies, the temozolomide plus cisplatin regimen may be a better choice than HDI. Our trial is unique in that it addresses adjuvant therapy for a specific, uncommon subtype of melanoma.

       

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        mary1233
        Participant

          I had this therapy for my mucosal melanoma. I am 25 months post surgery with no recurrence. According to the abstract written, I think they quit following people after 26 months.

          My treatment was pre anti pd-1 and I was told that had I presented six months earlier, there would have been nothing to offer me but the surgery. Since then I have been told that if it recurrs, immunotherapy will be the route. Yervoy is not known to be particularily effective on mucosal melanomas (at least as a monotherapy) so I am happy to have tried something that they actually had data indicating success. I view it as a step I had to take to wait until the science caught up to us in the mucosal category.

          Temozolomide is one of the few chemo drugs known to cross over into the brain, where melanoma is known to spread. That was comforting for me to know.

          My best wishes to all.

          Mary

           

           

          mary1233
          Participant

            I had this therapy for my mucosal melanoma. I am 25 months post surgery with no recurrence. According to the abstract written, I think they quit following people after 26 months.

            My treatment was pre anti pd-1 and I was told that had I presented six months earlier, there would have been nothing to offer me but the surgery. Since then I have been told that if it recurrs, immunotherapy will be the route. Yervoy is not known to be particularily effective on mucosal melanomas (at least as a monotherapy) so I am happy to have tried something that they actually had data indicating success. I view it as a step I had to take to wait until the science caught up to us in the mucosal category.

            Temozolomide is one of the few chemo drugs known to cross over into the brain, where melanoma is known to spread. That was comforting for me to know.

            My best wishes to all.

            Mary

             

             

            mary1233
            Participant

              I had this therapy for my mucosal melanoma. I am 25 months post surgery with no recurrence. According to the abstract written, I think they quit following people after 26 months.

              My treatment was pre anti pd-1 and I was told that had I presented six months earlier, there would have been nothing to offer me but the surgery. Since then I have been told that if it recurrs, immunotherapy will be the route. Yervoy is not known to be particularily effective on mucosal melanomas (at least as a monotherapy) so I am happy to have tried something that they actually had data indicating success. I view it as a step I had to take to wait until the science caught up to us in the mucosal category.

              Temozolomide is one of the few chemo drugs known to cross over into the brain, where melanoma is known to spread. That was comforting for me to know.

              My best wishes to all.

              Mary

               

               

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